marconyc: introduction

[marconyc]

@manymoretodays May I ask you a few questions about weighing aripiprazole for the purposes of tapering? I purchased the Gemini digital scale recommended on SA and calibrated it successfully. When I weighed a 2mg dose of aripiprazole on the scale, it came out to 0.090 grams, which equals 90 milligrams, I believe. I was surprised that a 2mg dose weighed that much. Does that seem right? I read that much of the weight may be filler, so perhaps that's correct.

 

Anyway, if a 2mg dose weighs 90 mg, then:

 

1mg dose = 45 mg

0.5mg dose = 22.5mg

0.25mg dose = 11.25 mg

 

Right now I'm actually taking about a 0.25 mg dose. I thought it was 0.2, but when I weighed the amount I'm taking, it was a little more than 11mg. 

 

Let's say I want to reduce my current dose by 10% next month. Is this how I do it? Calculate 10% of 11.25mg by multiplying 11.25 x 0.1, which equals 1.125mg. Then, subtract 1.125mg from 11.25mg, which equals 10.075mg. So, a 10% reduced dose would be 10.075mg. Am I correct?

 

Thanks for your patience!

 

 

[manymoretodays]

Happy to help you marco.

Do bear with me though.......as I'm on and off site now........working for balance in all things.  I can certainly get back to you, generally........within a week, on most questions.  I'm always checking in and following many here.

 

It does sound like you may have seen the topic/thread which is here:  Using a digital scale to measure doses

 

  On 3/21/2019 at 1:57 PM, marconyc said:

Right now I'm actually taking about a 0.25 mg dose. I thought it was 0.2, but when I weighed the amount I'm taking, it was a little more than 11mg.

 

So your reading in grams(what you see on your scale, when it's set on gm's) then was what?    .011 or .012?

 

  On 3/21/2019 at 1:57 PM, marconyc said:

Let's say I want to reduce my current dose by 10% next month. Is this how I do it? Calculate 10% of 11.25mg by multiplying 11.25 x 0.1, which equals 1.125mg. Then, subtract 1.125mg from 11.25mg, which equals 10.075mg. So, a 10% reduced dose would be 10.075mg. Am I correct?

 

We usually have you base the 10% calculation on the present dose in mgai(mg active ingredient, as opposed to the actual weight in mg or gram)

And this is how we do that: 

0.25 mgai X .90= .225 mg

 

The 0.225 mgai is then a 10% drop from your present dose of 0.25 mgai.

And then, always round up is the rule as well.

 

So......for your next 10% decrease you'd want to go with a 0.23 mgai dosage. 

 

Consistency in your calculations as well as measurement will be key here.  In harmfree reduction with your aripiprazole.

 

And I'll get you a bit more information that will be helpful, when I get some time.  You might find it useful to take a look at how brassmonkey did his taper,

when he got to lower doses, and weights of his Paxil.  I think, if you are comfortable with it,  perhaps an ending point for your aripiprazole taper might be somewhere around .05 mgai, or perhaps even less.

Let's see how you fare with this present HOLD and just allow your CNS time to find some homeostasis.

I'm hoping you can ease off the aripip with minimal discomfort or W/D symptoms this way.  Keep notes please!

 

Here's a link to brassmonkey's success story,  Tao of the Brassmonkey.  (the first post there will also link you to his introduction as well).  Hoping it will prove "inspirational" to you AND he has also done a lot of work, and shared it with us on the more technical aspects of working with the Gemini20, and math calculations.  Presently traveling the globe with his wife.......so, can only do brief check ins  for a bit. 

 

I am wanting to get the hang of it all too.......for future suggests and helping out around here.......so, good opportunity I say.

 

Okay, best.

Love, peace, healing, and growth,

mmt

p.s.  I am so hoping for news of an "oops" pregnancy for you and yours.  Sometimes that happens you know........after the IVF's.  Fingers crossed and best intentions.

 

  

 

Edited just now by manymoretodays

Edited March 23, 2019 by manymoretodays
links added, minor further edits, quotes color coded

[marconyc]

Hi @manymoretodays Thank you! I understand that you can't always respond right away. Being online all the time isn't healthy. I pasted your text in red below, and my responses in black.

 

So your reading in grams(what you see on your scale, when it's set on gm's) then was what?    .011 or .012?

 

Yes, I see .011 or .012 on the digital scale when I weigh the amount I'm taking. 

 

We usually have you base the 10% calculation on the present dose in mgai(mg active ingredient, as opposed to the actual weight in mg or gram)

And this is how we do that: 

0.25 mgai X .90= .225 mg

 

The 0.225 mgai is then a 10% drop from your present dose of 0.25 mgai.

And then, always round up is the rule as well.

 

So......for your next 10% decrease you'd want to go with a 0.23 mgai dosage. 

 

Okay, but then I have to calculate the weight of a 0.23mgai dose, correct? I think I'll need to go back to the topic on using a digital scale for instructions on how to do that. I'm sure it's based on the fact that for the aripiprazole I'm taking, a 2mg mgai dose weighs about 90mg. 

 

Let's see how you fare with this present HOLD and just allow your CNS time to find some homeostasis.

I'm hoping you can ease off the aripip with minimal discomfort or W/D symptoms this way.  Keep notes please!

 

Will do.

 

Okay, best.

Love, peace, healing, and growth,

mmt

p.s.  I am so hoping for news of an "oops" pregnancy for you and yours.  Sometimes that happens you know........after the IVF's.  Fingers crossed and best intentions.

 

Thank you again, for the encouragement, the information, and the kind words. Hope you are well.

 

[marconyc]

I’m having a tough time today. I’m feeling anxious and depressed. The weekend was pretty good—I played soccer, went running, and spent time with my wife and two dogs. I had some anxiety and depression but not too bad. Today, though, I started to feel icky in the afternoon. I think I spent too much time on Twitter arguing with obstinate psychiatrists about the reality of withdrawal. Maybe I also overdid the physical activity over the weekend between soccer and a long run. I might be kind of depleted. 

 

Anyway, withdrawal sucks. It’s wearing me down. I try to be positive and keep it together and tell myself I don’t need to be on meds to survive but sometimes it feels like I’m broken. It can be hard to stay confident that what I’m going through is withdrawal and not recurrence of some chronic mood disorder. I just want to cry. 

[marconyc]

Well, I think I'm in a wave. It feels like my body has fully registered the last cut to 0.25mg of Abilify. I slept fine last night (after a few weeks of insomnia) but now I feel fatigued and sleepy. It's like my nervous system keeps shifting back and forth between hyper- and hypoarousal. 

 

Plus, while I feel sleepy, I'm anxious as well and have lost my appetite. Maybe this anxiety is a secondary reaction to the fatigue. 

 

It's really surprising how much of an effect these tiny cuts can have. Wow.

[manymoretodays]

On 3/21/2019 at 1:57 PM, marconyc said:

Anyway, if a 2mg dose weighs 90 mg, then:

 

1mg dose = 45 mg

0.5mg dose = 22.5mg

0.25mg dose = 11.25 mg

 

Right now I'm actually taking about a 0.25 mg dose. I thought it was 0.2, but when I weighed the amount I'm taking, it was a little more than 11mg. 

 

Hey marco,

I'm real sorry that you are further struggling early this week.

And just wanted to comment on the above for now.

Yes, those calculations, so far look sound.

One additional thing so far is that we refer to the mg weight as mgpw(for mgpw) as opposed or compared to mgai(mgai).  This is important so that you don't get the dose mixed up with the weight.

 

So......I'll paraphrase your example above using those abbreviations:

 

2 mgai(the full dose of a tablet) is 90mgpw or .090 gmpw(the reading on your scale, which is in grams)

 

1 mgai = 45 mgpw or .045 gmpw(the reading on your scale, which is in grams)

0.5 mgai then is = 22.5 mgpw or .023 gmpw( as the Gem20 scale only goes to 3 digits after the decimal point, it's best to round up)

0. 25 mgai = 11.25 mgpw or .012 gmpw (I rounded up again.....see how that works?)

 

For now......just stick with the .012 gmpw or 12 mgpw for your 0.25 mgai dose.

 

Have a hopefully more window day today and I'll check on back soon.  And HOLD.

Good to see you getting around the site and offering support where you can too!!!

 

Best, love, peace, healing, and growth,

mmt

 

 

 

Edited March 28, 2019 by manymoretodays
oops, forgot a mgai, corrected

[marconyc]

Thanks as always @manymoretodays

 

I’ll stick with 12mgpw for now. No window yet. I’m feeling flu-like symptoms (fatigue, muscle aches, chills, pressure in head) as well as anxiety and some nausea. Very uncomfortable. Could also be some continuing symptoms of work burnout. It’s hard to differentiate at times. Anyway, I have an appt with my therapist tonight, which is good. More soon. Thank you again.

[marconyc]

@Altostrata I just saw your email exchange with Wendy Burn at the Royal College of Psychiatrists. It was on someone's blog and posted to Twitter. It's great that you were able to get her attention and show her how much more patients know about withdrawal than docs. 

[marconyc]

Feeling a little bit better today. I think part of the reason I've been in a wave is because of work stress, which is a continual issue for me. I'm starting to think that one of the reasons these drugs are prescribed and taken is to stay afloat in unsustainable living and working conditions. 

 

For everyone out there in Withdrawal Land: you're not alone. 

[powerback]

2 hours ago, marconyc said:

afloat in unsustainable living and working conditions. 

 

HI MC ,you've hit the nail on the head ,I suggest doing something that doesn't tax your system to much to relax  [I used too much exercise excessively  as a crutch in withdrawl and I snapped and crashed badly  .the exercise along with the emotional and mental factors all accumulated on top of me ,lately I get a cathartic crying  release from listening to  music ,tapping into all my   repressed emotional pain .

its not a coincidence the western world is so sick .  

Peace 🙏.

[marconyc]

I'm starting to realize that crying is powerful medicine. 

[powerback]

8 minutes ago, marconyc said:

I'm starting to realize that crying is powerful medicine. 

I was crying earlier ,it was fleeting and I was "oh no come back please " .

I wont be turning up to random funerals to get the emotion that's for sure .a nice comfortable safe environment to process and understand it .I was reading up on parenting my inner child ,its very interesting .my issues like many others  started many years ago in childhood and I can visualize that rejected scared  kid ,ok who's cutting onions ha.

Take care.

[marconyc]

I had therapy last night and cried very cleansing tears. My therapist specializes in "Internal Family Systems." I've found it to be a great approach.

[powerback]

2 minutes ago, marconyc said:

I had therapy last night and cried very cleansing tears. My therapist specializes in "Internal Family Systems." I've found it to be a great approach.

Everything  originates in the family dynamic ,that's for sure .hopefully with each generation less "junk" will be dumbed on the next  generation and so on to perfection ha [nasty word is that perfection ,no such thing ].

Good luck with your future healing. 

Take care.

[marconyc]

You too @powerback well said

[Altostrata]

21 hours ago, marconyc said:

@Altostrata I just saw your email exchange with Wendy Burn at the Royal College of Psychiatrists. It was on someone's blog and posted to Twitter. It's great that you were able to get her attention and show her how much more patients know about withdrawal than docs. 

 

Thanks, marco.

 

By all means, cry away and don't feel guilty about it!

[marconyc]

Haha, thank you!

[marconyc]

Today is my 24th day at 0.25mg of aripiprazole/day. Last week's wave seems to have receded. I don't know if I'm in a "window," but I'm doing okay. I'd like to hold for a bit so that I can give myself more time to heal before another cut. Holding will also help me gauge how much external stressors are playing a role in my symptoms. Any thoughts?

[Gridley]

12 minutes ago, marconyc said:

I'd like to hold for a bit

 

Good idea.  We've had lots of members write in regretting going too fast, not a one regretting going too slow.

[marconyc]

Okay, thanks @Gridley. I'll hold for a while. 

[marconyc]

Another good cry. I’m becoming a proud weeper. My symptoms quiet down so much when I feel my feelings. Therapy has helped a lot for me in this regard. And SA.

[manymoretodays]

18 hours ago, marconyc said:

Today is my 24th day at 0.25mg of aripiprazole/day. Last week's wave seems to have receded. I don't know if I'm in a "window," but I'm doing okay. I'd like to hold for a bit so that I can give myself more time to heal before another cut. Holding will also help me gauge how much external stressors are playing a role in my symptoms. Any thoughts?

 

Awesome marconyc!

And that sounds about right, the time frame.........2 weeks plus a bit for things to even on out with the reinstatement of the aripiprazole.

Do you have a exact date for when you added it back?  I'm thinking around the 17th of March, from your journal here. Which puts you just a bit past 2 weeks.

Welcome to the proud weeper club!  Out loud laugh. 

[marconyc]

@manymoretodays I think I reinstated on March 11. Yes, it seems to take a couple of weeks to fully register a change in aripiprazole dose, especially a cut, which I imagine is due to the relatively long half-life. Although I'm not symptom-free, I seem to be back to my WD Normal baseline. Actually, my WD Normal might be improving a bit over time--for ex, I've been noticing less DP/hypervigilance, even in response to major stressors. Right now my sleep has pretty much returned to normal after a nasty jag of insomnia that was most likely caused by the drop in aripiprazole. 

[marconyc]

@Gridley @manymoretodays Today is the 28th day for me at 0.25mgai of aripiprazole. (I mistakenly wrote in a previous post that I reinstated on March 11; I actually reinstated on March 9.) 

 

I'm feeling "WD Normal." My understanding of WD Normal is that it refers to my personally tolerable average baseline during withdrawal--in other words, the state where I'm not asymptomatic, but I'm able to live my life and tolerate the symptoms that arise. My WD Normal also seems to be improving ever so slightly over time. 

 

Do you think I'd be okay trying a 10% cut of the aripirazole at this point?

[Gridley]

28 minutes ago, marconyc said:

 

 

Do you think I'd be okay trying a 10% cut of the aripirazole at this point?

 You've dropped from .75 to .25 in 4 months, a very fast taper especially at these low doses.  I'd continue to hold.

[marconyc]

Okay, will do @Gridley Any thoughts on how much longer I should wait? 

[Gridley]

53 minutes ago, marconyc said:

Any thoughts on how much longer I should wait? 

 

It will depend on how you feel.  As you know, there are no hard and fast guidelines.  Let's see how you feel in two more weeks.

[marconyc]

Okey doke @Gridley thanks again

[marconyc]

@Altostrata just wanted to let you know that I tweet as Volpone. Great to see the response from Wendy Burn. This site is doing a lot of good. 

[marconyc]

My wife and I just found out that she is pregnant. I’m overjoyed but also starting to feel overwhelmed. Yesterday and today I’ve noticed more symptoms—mostly anxiety but also tearfulness, emotional lability, and obsessiveness. At first I thought, “What’s wrong with me? I’ve wanted this for years. I shouldn’t be feeling this way. Maybe this is just med-related.” But now I think the reality of pregnancy and fatherhood is settling in, and I’m trying to avoid the mix of powerful emotions that are coming up. I’m also worried that I won’t be able to handle this. 

[wantrelief]

Oh my goodness....congratulations, marconyc!!  I was so happy to read your post.  It is natural to feel overwhelmed with this news.  It will probably take time for this to settle but it will.  In the meantime, we are here to support you so you are not alone with everything that is arising emotionally.  

[RichT]

Congratulations Marconyc,

 

if you've wanted this for years then I'm sure you can trust in that.

[marconyc]

Thank you @wantrelief I have always had a tendency to think strong emotions are dangerous because of my upbringing. And then being diagnosed with dysthymia and GAD probably reinforced this sense that something is wrong with me for having strong emotions. Therapy is teaching me that I’m not abnormal, but change is slow and takes a lot of effort.

[marconyc]

Thanks you @RichT I have. My wife was the hesitant one. And now she is pretty freaked out, so I’m trying to comfort her and not show that I have my own fears. 

[wantrelief]

Ah, I see....that is all very insightful.  That is great that therapy is helping you understand that having strong emotions does not indicate something is wrong with you.  But, yes, change is indeed slow and takes a lot of effort.  Sigh.

[marconyc]

Bad anxiety this morning. I’m pretty sure it’s anticipatory anxiety about my wife’s pregnancy. I’m trying to take deep breaths and remind the scared parts of me that we can do this, but it’s hard. I’m tempted to updose the Abilify or even take some Klonopin. I definitely do not want to do either, but this anxiety sucks. I’m not having panic attacks but I feel tense, nauseous, with a pit in my stomach and a feeling of dread.